A Phony Heterosexual

In my first year as a premedical student at the University of Rochester, I began working as an EMT (emergency medical technician).

I enjoyed the work, but my interactions with patients were necessarily fast-paced and fleeting. In September of my senior year, I explored a different side of medicine by volunteering at a local hospice house; there, engaging with patients and hearing their stories over time was a critical element of care.

Among the hospice patients, I connected especially to Jackson, a man in his sixties. Jackson’s voice, interests and punk style reminded me of my own grandfather, who had passed away just a year earlier.

Like my grandfather, Jackson seemed unconcerned about fitting the “normal” mold. My grandfather had sported neon coats and feathered hats, while Jackson wore bold silver jewelry and long rocker hair. As avid smokers and drinkers, Jackson and my grandfather would surely have become brotherly companions if they’d ever met.

My grandfather and I were close. He always supported me, even when I came out as gay, and he always made me feel I had the potential to make an impact. Because Jackson so resembled my grandfather, a sense of camaraderie quickly developed between us.

We first bonded over cooking, discussing our favorite dishes and cuisines. He described his love of home-cooked meals, and I shared fond memories of my parents’ preparing comfort food like brisket and babka. When I confided my love of hot sauce, Jackson laughed and said, ”You know, they don’t have anything spicy here! I tried looking for hot sauce in the kitchen, but nothing!”

On my next shift, I made sure to bring him a bottle of smoked Tabasco from home.

After some time, Jackson began mentioning his desire for female companionship, and his struggles with dating. (Because the hospice house was fairly small, patients were permitted to host partners.) Jackson was no stranger to online dating and frequently criticized “scammer profiles.” He told me that he was looking for meaningful physical intimacy.

As a gay man, I wasn’t accustomed to these types of conversations. Rarely did heterosexual men share their relationship struggles with me, and never had I engaged in this sort of dialogue as a healthcare provider. To add to my uneasiness, I thought that Jackson might be sharing his concerns with me because he saw me as a straight man with multiple female partners.

“How are your girlfriends?” he would ask jokingly. “Ladies’ man, you must be. You dog!”

In response, I would chuckle nervously, hoping that my rosy cheeks would convey the heteronormative mantra “Gentlemen don’t kiss and tell.”

I don’t usually disclose my queer identity in medical settings. I’m often fearful of a negative response, and usually this side of my identity is irrelevant to my patients. In fact, I often find myself actively hiding my queer identity: In a heteronormative world, I feel safer that way.

However, Jackson’s assumptions provoked an internal debate. I wondered if my façade of straightness was somehow wrong.

Have I gained Jackson’s trust under false pretenses? I asked myself. If he knew the truth, would he have preferred to confide in a different volunteer—someone who was genuinely straight? What if he discovers that I’m a phony heterosexual?

I knew that Jackson might feel just as comfortable sharing his dating challenges with me even if he knew I were gay. He might feel safe sharing his concerns with me simply because I was an attentive, empathetic listener, and because we shared a friendly bond.

Still, the internal dialogue continued. I considered that Jackson might have trusted that I could relate to his struggles as a man because he assumed that we enjoyed a mutual understanding and shared experience of heterosexuality. With this in mind, I wondered, What if, when Jackson first asked about my girlfriends, I had told him about my boyfriend? Would I have taken something away from him—the sense that he had a peer who truly understood him?

Ultimately, I maintained the façade of heterosexuality with Jackson, and we remained good friends until I returned home to Canada for medical school. After that, I kept up to date on his care through the hospice’s weekly emails. Although Jackson passed away in the summer, I still think about him from time to time, remembering his humor and bold sense of style.

Looking back, I don’t regret the decision to hide my sexual identity. Jackson’s desire was for physical and emotional intimacy with a partner—a basic desire that transcends variations in sexuality, and one that I feel I understood, despite our different identities.

During my time with Jackson, I wondered if I’d wronged him by concealing an important element of my identity. As I progress in medicine, I’ll encounter many more patients, and I’m unsure if it will be wise to hide my identity so frequently.

Just last week, when buying custom scrubs, I passed up the pride-flag chest embroidery for a less controversial llama emblem. In making that choice, I wondered if I was depriving my future queer patients of a subtle sign of commonality that might have helped them feel more comfortable.

I know that a provider’s self-disclosure can be inappropriate or unnecessary—but I also see self-disclosure as a potential tool. In cases where I sense that sharing my personal identity or feelings could help my patient to feel more at ease about disclosing sensitive medical information, I will take a chance and reveal the entire, human side of me.